hypnotics | CARLAT PUBLISHING

Clinical Update

When Shorter Is Better

April 14, 2023

Chris Aiken, MD. Editor-in-Chief of The Carlat Psychiatry Report; Assistant Professor, NYU Langone Department of Psychiatry; practicing psychiatrist, Winston-Salem, NC.

Dr. Aiken has no financial relationships with companies related to this material.

Four scenarios where a time-limited approach to medication is ideal.

Benzodiazepines: A Reevaluation of Their Benefits and Dangers

August 23, 2022

Carl Salzman MD

Carl Salzman, MD

Professor of Psychiatry at Harvard Medical School and past chairman of the American Psychiatric Association Benzodiazepine Task Force. Interview by Marcia L. Zuckerman, MD. Board member of The Carlat Psychiatry Report; outpatient psychiatrist, Hallmark Health, Medford, MA; clinical assistant professor in psychiatry, Tufts School of Medicine. Edited by Chris Aiken, MD. Editor-in-Chief of TCPR; practicing psychiatrist, Winston-Salem, NC.

Drs. Salzman, Zuckerman, and Aiken have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Former Chairman of the American Psychiatric Association Benzodiazepine Task Force Carl Salzman explains the legitimate medical use of benzodiazepines and their relevance in psychiatric practice.

Lemborexant and Sleep Architecture in the Elderly

August 3, 2021

Garrett Rossi, MD.

Garrett Rossi, MD. Dr. Rossi has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

It’s rare to see a hypnotic that improves sleep architecture, not to mention next-day functioning. Lemborexant hopes to change that.

Mood, Cognition, and Metabolic Health

March 26, 2021

Rodrigo Barbachan Mansur, MD

Rodrigo Barbachan Mansur, MD

Assistant Professor, Division of Brain and Therapeutics, University of Toronto. Dr. Mansur has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Does eszopiclone (Lunesta) have therapeutic effects beyond insomnia? Possibly in depression and anxiety, but the jury is still out in PTSD.

Rest Easy: Benzos, Z-Drugs, and Dementia

December 31, 2020

James Jenkins, MD.

James Jenkins, MD. Dr. Jenkins has disclosed that he has stock in Alkermes, Sage Therapeutics, Teva Pharmaceutical Industries, Trevena, and Viatris. Dr. Aiken has reviewed this article and has found no evidence of bias pertaining to this educational activity.

It may not be perfect, but this study has the best data yet on the controversial link between benzodiazepines and dementia.

Is Ramelteon an Effective Hypnotic?

November 12, 2020

Randall Moore, MD, JD. and Chris Aiken, MD.

Randall Moore, MD, JD. Clinical Associate Professor, Department of Psychiatry and Behavioral Sciences at Texas A&M Health Science Center College of Medicine. Chris Aiken, MD. Editor-in-Chief of TCPR. Practicing psychiatrist, Winston-Salem, NC. Dr. Moore and Dr. Aiken have disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Ramelteon (Rozerem) is one of the safer sleep medications, but how well does its efficacy stack up against other hypnotics? The answer surprised us.

How to Safely Prescribe Z-Drugs

August 13, 2020

There’s good reason to be careful prescribing Z-drugs. Here’s an overview of Dr. Reban Aziz’s recent article in The Carlat Addiction Treatment Report.Safety Tips Go short-term or intermittent to reduce the potential for adverse events and withdrawal. Avoid for SUD or complex sleep disorders. Use as last resort after considering...

Study Ignites Controversy Over Trazodone and Suicide

May 7, 2020

Eugene Rubin, MD.

Eugene Rubin, MD. Dr. Rubin has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

When researchers at the Department of Veteran Affairs found a 61% increase in suicide attempts when veterans took trazodone vs. zolpidem for sleep, the story made headlines. We tease apart the strengths and weaknesses of this 350,000 subject study to see what the real risk is.

Lumateperone and lemborexant

March 9, 2020

The antipsychotic lumateperone (Caplyta) and the hypnotic lemborexant (Dayvigo) are the newest in their class. Both of them claim to improve on the safety of older medications, and we look at the data to see how those claims hold up.

A New Contraindication for Ambien and the Z-Hypnotics

August 30, 2019

Chris Aiken, MD Talia Puzantian, PharmD, BCPP

Chris Aiken, MD Talia Puzantian, PharmD, BCPP Dr. Aiken and Dr. Puzantian have disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.

The FDA rarely issues absolute contraindications, but that’s where their language is tilting in a new warning on Z-Hypnotics. We look at the data behind their decision and offer six tips for safer prescribing of sleep medications.